Information Session for Yale/Stanford Global Health Scholars Program 2020 - Rwanda

December 03, 2020

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00:00Hey everyone, I'm Jeff.
00:02I just graduated from the trad
00:05program this past year and actually
00:08did the distinction pathway.
00:10Map which. I did.
00:13It was definitely one of the
00:15highlights of my residency experience,
00:18so if anyone's interested in that,
00:20has any questions,
00:21feel free to reach out.
00:23I was very glad that I
00:26did it during residency.
00:27I went to Rwanda during
00:29November of my third year,
00:31so right before covid happened and
00:33I chose were Wanda mainly because
00:36I was interested in development
00:38of their health care system after
00:41genocide and really wanted to see.
00:43What things have looked like in the decade?
00:46Plus since that happened?
00:49And was really happy that I did.
00:53Let me share my screen.
01:21Sorry, one second.
01:28There we go. So Rwanda is in East Africa.
01:32It is bordered by the DRC
01:34and Uganda to the North,
01:36and then Burundi and Tanzania to the South,
01:39and southeast Kigali,
01:40which is where at the Central Hospital,
01:42is that I rotated at is kind of
01:44in the middle.
01:46There is another site that you can
01:48go to in Butare and they actually
01:50have a large Cancer Center which is
01:53pretty well known there and in the
01:55North you can see the room mountains,
01:57which is where a lot of people.
02:01During their trips,
02:02will go to see the gorillas,
02:04which is pretty cool.
02:08Like we talked about,
02:09the genocide had a huge impact on
02:12health care in Rwanda in the early 90s.
02:14They actually had the lowest life
02:17expectancy out of any country in the world.
02:20And the rates of infectious disease and
02:23unsafe Earth skyrocketed as a result of this.
02:26In the mid 90s. Since then,
02:30they've actually developed quite a bit.
02:32Paul Kagame is the current president
02:34who actually led the Rwandan Patriotic
02:37Front during the genocide and became,
02:39I think there's six president,
02:42and he's done a lot for them in terms of
02:45their economy and healthcare development.
02:48Part of this was the human resources
02:51for health Program, or HRH.
02:53It was launched in 2012 and was seven
02:56years in duration and they basically.
02:59Sent over a lot of US faculty
03:02members to collaborate with.
03:04The faculty there and train a
03:06lot of their medical students,
03:08senior residents and attendings
03:10based basically just strengthen their
03:12own health care infrastructure so
03:14that when the US presence was gone,
03:16they'd be able to still sustain that.
03:22This is the entrance to the hospital.
03:26Where you came in every day and
03:28there is one of the ambulances.
03:31All of the buildings or kind of
03:33these small one story buildings,
03:35which are the wards?
03:37And there's one male Ward,
03:39one female warden, then one word for
03:41TB patients for internal medicine,
03:43and then there is opian
03:45surgical wards as well,
03:47and this is their OB pavilion,
03:49which is really nice.
03:50I'd go here during my lunch
03:53breaks throughout the day,
03:54and they're all.
04:25Teaching if you're interested in
04:27that and mentorship their own,
04:29residents are frequently busy,
04:31and so they will rely on you a lot
04:34to help lead noon conferences for the
04:37Med students and morning reports.
04:39And that was actually probably one
04:41of the highlights of the experience
04:44is going to work really closely
04:46with these students who are highly
04:49motivated and really just sweet.
04:52Because there is a,
04:53you know, limited resources,
04:55and you can't always rely on
04:57advanced diagnostic techniques.
04:58You really have to rely on
05:00physical exam skills,
05:01which is something we learned from
05:03one of their senior physicians there.
05:06This was a cool case of a patient
05:08whose family members had said that
05:11his Palmer Skinhead darkened a lot,
05:13which was unusual.
05:14It was more the color of his
05:17wife skin that you can see in
05:20the picture next to him and.
05:22Based on just a physical exam
05:24and his hypo tension,
05:26the like senior doctors basically
05:28like the equipment doctor Duffy.
05:31There was able to make a
05:33diagnosis of Addison's disease,
05:35adrenal crisis which was really cool
05:38because the skin hyperpigmentation.
05:40Um,
05:40so that was really neat and something
05:43definitely that I got to work on.
05:45I think the bedside,
05:46rounding and interaction with
05:48patients was far more than like
05:50any other experience I've had.
05:52This this is a picture of me
05:54with all the Med students after
05:56one of our like lunch meetings.
05:58We did a lot of different topics like DKA,
06:01diabetic emergencies,
06:02just basic bread and butter medicine topics.
06:05On another picture, they were all very sweet.
06:09An in Kigali.
06:10At the time there was also the
06:12women leaders in Global Health
06:13Conference which I had to attend,
06:15which was a cool experience.
06:17There's always a lot of different
06:19lectures on educational opportunities to,
06:20I think because there are a lot of.
06:24Faculty that are always coming.
06:25This is actually Jeanette Kagame.
06:27She works very closely with
06:29the Ministry of Health.
06:30She's their first lady,
06:31so it was really cool to get to
06:34hear her speak at this event.
06:36Kigali also has a lot of coffee shop,
06:39so I tried to go to at least each of them.
06:43This is one of my favorite
06:45called Question Coffee.
06:46It's sourced locally from women in nearby
06:48areas that are their own coffee beans.
06:51This is another one of my
06:53favorite cafes you can have.
06:55You see a really nice view
06:58of the city around it.
07:00This is an example of a typical Rwandan meal.
07:03They'll eat a lot of green bananas,
07:05which was new to me and cook.
07:08It can taste like potatoes.
07:09A lot of fish different like
07:12rice and spinach and stuff.
07:15This is a picture of a girl I
07:16saw at the Volcanoes National
07:17Park which was also a highlight
07:19and if you're into the outdoors,
07:21there's a lot of great hikes.
07:23There's like IBEW as well,
07:24so every weekend we were trying to
07:26do a trip to one of these period.
07:29This is at the entrance of the park.
07:32And this is just another picture.
07:34Rwanda is known as the Land of 1000 Hills,
07:38and so it's super scenic
07:40and very picturesque.
07:41There's always a bunch of
07:43rolling Hills everywhere.
07:44This is actually the view from
07:47my apartment balcony during the
07:49last sunset that I was there.
07:51If you have any questions,
07:53my email is right there, thank you.
07:59Great, thanks so much.
08:00If A and I see Andre is
08:02here as well. If folks have questions,
08:05feel free to put them in the chat
08:07or you know we have a minute or two.
08:09If anybody wants to ask
08:11a question now or Andre,
08:12I don't know if you wanted to add
08:15anything to that presentation.
08:17Well, I can ask you for a question and
08:19then if there's time I can talk after.
08:21But what was your living
08:23arrangement like and how did
08:24you find getting around Kigali?
08:26I'm getting around is really easy.
08:28I looked within walking distance to the
08:31hospital and kind of in the downtown area.
08:33There are a few apartment complexes
08:35and a lot of expats live there
08:37and so I found them through this
08:40like living in Kigali website. So
08:42it was about like half a mile walk
08:44to the hospital in a nice
08:47like furnished apartment.
08:49Yeah, there's definitely
08:50a lot of living options,
08:51and you work primarily
08:52in the inpatient setting.
08:53It sounds like.
08:54Did you do anything in
08:56the outpatient setting?
08:56No, I worked only in the wards. Kay? Thanks.
09:03Read. Alright, thank you so
09:06much for much appreciated.